On a broad scope, keeping up with the latest evidence-based practice in healthcare can be a difficult task for nurses. The amount of evidence-based information available can be overwhelming. When you compound that with the challenge of finding the latest information on a smaller scope in a specialized area of the medical field it can be even more daunting. One tool that nurses can use to make that search easier is to formulate a clinical question in the PICOT format. A PICOT question is designed to make searching for that information easier by gathering feedback from others. This paper will define what a PICOT question is, identify a need for change in my current work environment and formulate a PICOT question to help me gather evidence to help facilitate that change. PICOT Defined The PICOT format is composed of five different components. The (P) stands for the population of interest that the question is directed toward. This could be a broad population such as all people diagnosed with type 2 diabetes or smaller in scope such as males over 45 years of age diagnosed with type 2 diabetes. The next component is the (I), which represents the intervention or issue of interest. This could be the use of a particular medication or procedure, such as lab tests, to address and understand the patient’s problem. The (C) component is the comparison of interest. This may include a control group of patients that were given a placebo or the intervention was the usual standard of care. The (O) component is the expected outcome of the intervention implemented. It is important to include the expected outcome of an intervention into the form of the question because it can enable the person doing the research to find existing evidence... ... middle of paper ... ...le, “Recovery of evidence-based practice” highlights the importance of utilizing evidence-based practice to care for mentally ill patients. “They also found a similar consensus in requirements that mental health care be based on evidence, be focused on effective treatments and best practices, and result in measurable outcomes” (Gordon & Ellis, 2013, p. 4). Conclusion In conclusion, I believe that formulating a PICOT question can be an effective way for nurses to find pertinent information quicker and easier with increased relevance to the intended subject. It can assist with finding stronger supporting evidence that can help nurses make better clinical decisions and bring about change where needed for patient safety and satisfaction. By utilizing the PICOT format, nurses can help formulate new interventions that will lead to better outcomes for the patients.
The Johns Hopkins Nursing Evidence-Based Practice Model provides nurses with a system to formulate a practice question, appraise both research and non-research evidence, and to develop recommendations for practice (Dearholt & Dang, 2012). This model guides nurses through the evidence-based research process with ease and minimal difficulty using a problem solving approach.
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
Evidence Based Practice is a growing field in the social work arena. The essence of evidence-based practice is placing the client’s benefits first by posing specific questions of importance to the client, searching objectively and efficiently for the best evidence, and then using the evidence to guide one’s practice. In short, evidence-based practice is the integration of research into practice. In this paper I illustrate the steps of evidence-based practice from the formation of a COPES question to the identification of practice guidelines.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
What is meant by evidence-based practice and how is this different from an historical standpoint.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
(Wilcock ,2001) states that it is essential to break it down into occupations and science. Occupations are daily activities that provide structure for living, reflect cultural values and have meanings for individuals. In addition, the science aspect is the gathering of knowledge through systematic reviews, randomised controlled trials and available resources that informs practice. The information therapist seeks for is that which has been critically appraised by other authors for validity and interpretability when planning and implementing treatment.This evidence based practice is usually defined as'the conscientious, explicit,and judicious use of current best evidence in making decisions about the care of individual patients’ (Dirette et al, 2009).
"Studies Say Mental Illness Too Often Goes Untreated." Los Angeles Times. Los Angeles Times, 07 June 2005. Web. 08 May 2014.
... practices are required as proof of effectiveness. Only time will tell if solution-focused therapy will prove to be evidence based practice (Norcross).
EBP incorporates an organized search for the best up to date empirical research, with clinical expertise, to answer a focused clinical question concerning a patient or a quality improvement issue in the clinical environment. The focused question addresses the patient population, area of interest, comparison intervention or control group, and desired outcome (PICO). Using this question style saves the nurse time and will yield the best available relevant evidence.
Although the legislation is evidence-based, it does not depend on local resources driven from within the mental health organizations involved in this case. In addition, it involves outsiders to reinforce the change in a comprehensive manner, covering all the mental health centers.... ... middle of paper ... ...
The purpose of this paper is to analyze a concept on order to identify an inconsistency and area for practical research. A clinical experience will be used to illustrate a core curriculum concept. Consistency with our text will be explored. Next inconsistencies will be identified to provide the basis for a relevant research question in PICO format. The process of conducting research using the hierarchy of evidence will be discussed. A summary of research findings will be provided and used to support modifications in future nursing practice.
I know this week you had a hard time finding a guideline that suited your PICOT question. Although you couldn’t find an article reviewing alcohol-impregnated caps understanding how to prevent intravascular infections definitely relates to your topic. In your summary I wish you have discussed some of the major recommendations. Other than that I believe you did a great job on this assignment. One item I thought was interesting was how the guideline discussed umbilical catheters. I honestly had never heard of this before, so it was a learning experience for me. “Umbilical venous catheters should be removed as soon as possible when no longer needed, but can be used up to 14 days if managed aseptically” (National Guideline Clearinghouse, 2011).
One of the most essential aspects of doing a job well, no matter what job it is, is the ability to think critically about a situation. Finn (2011) defines critical thinking as “the ability and willingness to assess claims and make objective judgments on the basis of well-supported reasons and evidence rather than emotion or anecdote”. The difference between assessing a certain situation critically and assessing it without any evidence to corroborate your claims is that when you look at something critically, you are using your ability to “come up with the alternative explanations for events, think of research findings and apply new knowledge to social and personal problems” (Finn, 2011). When you can come up with other explanations using evidence, you can also create an alternative way of enhancing the situation. Critical thinking skills are especially important to nurses in a fast-paced setting. Nursing is a very demanding and rewarding field to enter into; it becomes enjoyable when you are good at it. In order to be good at their jobs, nurses need to learn the skills required to think critically and also, relate those skills to their everyday routines. This is known as evidence-based practice. Evidence-based practice is defined as “using the best scientific evidence available to guide clinical decisions and interventions with the goals of fostering self-management skills and improving health outcomes” (Miller, 2011). This paper examines the skills required for critical thinking, how to learn these skills, and how to apply them in clinical settings. (Miller, 2011; Finn, 2011; Noonan, 2011; Lunney, 2010; Wangensteen, Johansson, Bjorkstrom & Nordstrom, 2010; Chitty & Black, 2011).
PICO questions are important because it allows nurses to continue to provide safe, effective patient care by formulating clinical questions that can be answered through research of published studies and clinical expertise to improve patient outcomes by improving nursing standards, protocols, and policies (LoBiondo-Wood, & Haber, 2014). Each element of the PICO question is important because it provides a framework for nurses to develop the clinical question. Identifying the population allows the nurse to pinpoint the patient population or primary problem (McKeon, & McKeon, 2015). The intervention identifies the what is the main component that needs to be addressed for the patient, such as diagnostic test, treatments, therapies, medications